RESUMEN
BACKGROUND: The Proximal Femoral Nail Antirotation (PFNA) system for treatment of intertrochanteric fractures is currently widely applied worldwide. However, even though the PFNA has produced good clinical outcomes, a poor introduction technique with an inappropriate entry point can cause surgical complications. Some researchers suggest improving clinical outcomes by modifying the entry point, but no research has focused on this issue. The purpose of the present study is to compare the clinical and radiological outcomes of two different trochanteric entry points for the treatment of intertrochanteric fractures using the PFNA system. METHODS: From May 2010 to October 2015, a total of 212 elderly patients with intertrochanteric fractures who were treated with the PFNA-II system were included into this retrospective cohort study. Group LA (98 patients) was treated using a lateral anterior trochanteric entry point, and group MP (114 patients) was treated using a medial posterior trochanteric entry point. All patients underwent follow-up assessments at 1, 3, 6, and 12 months after surgery. Radiographic evaluation was based on the impingement, tip-apex distance (TAD) and the position of the helical blade within the femoral head. Clinical evaluation was based on the surgical time, fluoroscopy time, blood loss, hospital stay, visual analogue scale (VAS), thigh pain, and Harris hip score. RESULTS: The impingement was significantly reduced (P = 0.011) in group MP. The helical blade positions were significantly lower (P = 0.001) in group MP. The TADs in group LA (22.40 ± 4.43) and group MP (23.39 ± 3.60) were not significantly different (P = 0.075). The fluoroscopy time of group LA (53.26 ± 14.44) was shorter than that of group MP (63.29 ± 11.12, P = 0.000). Five iatrogenic lateral proximal fractures and 3 helical blade cutouts occurred in group LA, but none occurred in group MP. At 1 and 3 months postoperation, the Harris hip scores were significantly higher in group MP (P = 0.001 and P = 0.000, respectively), and the VAS scores were lower (P < 0.05). CONCLUSIONS: The medial posterior trochanteric entry point achieved excellent nail and helical blade position, reduced surgical complications, and enabled early hip function recovery but required longer fluoroscopy time than the lateral anterior trochanteric entry point.
Asunto(s)
Fracturas de Cadera/diagnóstico por imagen , Fracturas de Cadera/cirugía , Complicaciones Posoperatorias/prevención & control , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Fracturas de Cadera/epidemiología , Humanos , Masculino , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Methylene blue (MB) attenuates acute lung injury (ALI) induced by liver or pancreas ischemia-reperfusion. But the protective effects of MB on paraquat (PQ)-induced ALI have not been elucidated. In this study, we aimed to study the effects of MB on ALI caused by PQ in rats. Male Sprague-Dawley rats were challenged acutely by PQ (25mg/kg, i.p.) with or without MB posttreatment (2mg/kg, i.p.) 2h after PQ administration. Lung specimens and the bronchoalveolar lavage fluid were isolated for pathological examinations and biochemical analyses 24h after PQ exposure. We found that the administration of MB significantly increased the activity of superoxide dismutase and decreased lung wet dry radio, the content of malondialdehyde and lactate dehydrogenase, the total cell number and the level of myeloperoxidase in bronchoalveolar lavage fluid. Pathological examination also revealed that MB alleviated PQ-induced histological damage. These results provide evidence that MB may be a new therapy in the treatment of PQ-induced ALI.
Asunto(s)
Lesión Pulmonar Aguda/tratamiento farmacológico , Líquido del Lavado Bronquioalveolar/inmunología , Pulmón/efectos de los fármacos , Azul de Metileno/administración & dosificación , Paraquat/toxicidad , Lesión Pulmonar Aguda/inducido químicamente , Lesión Pulmonar Aguda/metabolismo , Animales , Líquido del Lavado Bronquioalveolar/citología , Células Cultivadas , L-Lactato Deshidrogenasa/metabolismo , Pulmón/metabolismo , Pulmón/patología , Masculino , Malondialdehído/metabolismo , Estrés Oxidativo/efectos de los fármacos , Peroxidasa/metabolismo , Ratas , Ratas Sprague-Dawley , Superóxido Dismutasa/metabolismoRESUMEN
Being a biologic toxin, scorpion toxins have complicate physiologic and pharmalogic actions because of its intricate components. This text reviewed the effect of scorpion toxins on endothelial cell function, platelet function, microcirculation, atherosclerosis, ironic channel, and cardiac function.